Rushed nurses 'have to ration care'

Comforting and talking with patients was the most common activity to be axed by busy nurses

Hospital nurses are being forced to "ration care" because they do not have enough time to properly look after patients, a new study suggests.

Fundamental aspects of care are "frequently being left undone", researchers found. Almost nine in ten nurses questioned said they were so busy on their last shift that they were unable to perform at least one "care activity" such as proper patient surveillance, documenting care, administering medication properly, comforting patients, preparing them for discharge or changing a patients' position in bed - to prevent bed sores.

The study, published in the online journal BMJ Quality & Safety, examined data from almost 3,000 nurses who work in 46 English hospitals. They were asked whether they were unable to perform basic care elements because of time constraints.

The authors from the Florence Nightingale School of Nursing and Midwifery and the University of Southampton found that 86% of nurses were unable to perform at least one of 13 care elements because they were too busy.

Comforting and talking with patients was the most common activity to be axed by busy nurses, with 66% saying that they did not have time to do this on their last shift. Just over half of nurses said they were forced to skip "educating patients" and 47% said they did not have time to develop or update nursing care plans.

They found that the average nurse cared for 7.8 patients on a day shift and 10.9 at night. The fewer patients a nurse looked after, the less likely care would be missed or rationed, the authors found. Nurses looking after 11 or more patients were twice as likely to say they rationed patient monitoring as those looking after six or fewer patients.

Gail Adams, head of nursing at the union Unison, said: "This report adds to the growing evidence that there is safety in numbers when it comes to caring for patients. Earlier this year Unison's own survey of nurses and healthcare assistants found that nearly 60% did not have enough time to deliver safe, dignified and compassionate patient care.

"The introduction of minimum staff to patient ratios would be a life-saving initiative - one that would dramatically change life on the wards for patients and staff, providing a safer, more caring environment for all."

Dr Peter Carter, general secretary of the Royal College of Nursing, said: "These are depressing findings and unfortunately not surprising... Cutting nursing posts to save money is a false economy - it leads to poor care, which in turn creates more strain on the system, particularly in accident and emergency departments. We need to prevent poor care by making sure wards are well-staffed, not just use poor care as an early warning sign. We urge all employers to make use of this research."

A Department of Health spokeswoman said: "Hospitals themselves must decide how many and which staff they employ. But we have been absolutely clear that these decisions must be based on providing the best patient care and hospitals should publish details and evidence to show that staffing numbers are right for the care needs of the patients that they look after."